Vit B12 Research Articles

STUDY OF VITAMIN B12 LEVELS IN PATIENT WITH TYPE 2 DIABETES MELLITUS

Aims :-Evaluation of serum Vitamin B12 levels in type 2 diabetic population. Objectives:-1) To define the prevalence of vitamin B12 deficiency in type 2 diabetic population.2) To determine the risk factors associated with Vit B12 deficiency in type 2 diabetes like Age and Metformin use.3) To Assess the co-relation of Serum B12 levels and Diabetic Retinopathy in Type II Diabetes mellitus. Material and Methods:-This case control study was conducted in OPD of Department of General Medicine, Sarvajanik Hospital, Pune between June 2012 to May 2013. A total of 50 type 2 Diabetes Mellitus patients and 50 controls between 40 to 60 years were included. Serum Vitamin B12 levels and serum homocysteine levels were measured in all patients. Results:-The Vitamin B12 deficiency was present in 56% of the diabetics and 32% of the non-diabetics. Vitamin B12 deficiency was present in 48.4% of patients who were not on metformin and 68.4% of than those were on metformin. No significant increase in the prevalence of neuropathy, anaemia, or MCV was found in the Vitamin B12 deficient patients as compared to patients with normal Conclusions:- The study has shown that the diabetes was common after the age of 40 years. Male sex, Overweight and Obesity were other risk factors. Majority of the patients in this study had the diabetes more than 5 years and their blood sugar markers were disturbed. This study has shown that the vitamin B12 deficiency was found in more than half of the diabetics, metformin users and those who were on vegetarian diet.

The frequency of vitamin B12 derangements in females presenting for workup of iron deficiency anemia

Objective: Iron deficiency anemia (IDA) is the most prevalent hematological disorder in women of child-bearing age. IDA poses a threat to feto-maternal wellbeing. It is the leading cause of morbidity and mortality in pregnancy. IDA in young females can coexist with other nutritional deficiencies such as vitamin B12 (Vit B12). An undetected Vit B12 deficiency carries a greater likelihood of development of maternal neuropsychiatric disorders and neural tube defects in the fetus. Materials and methods: Venous blood samples of non-pregnant female population (N=133) from Fauji Foundation Hospital, Rawalpindi were collected and analyzed for complete blood count (CBC), Vit B12 and serum Ferritin. Population was further subdivided into two groups. Group A, included females with low serum Ferritin and low MCV, group B restricted to normal serum Ferritin and low MCV, whereas control group had females with normal serum Ferritin and MCV levels. Results: Demographic data suggested that only height was slightly lower in IDA patients other than reduced serum Ferritin levels. Group A also showed reduced levels of Vit B12 as compared to group B and control group. CBC analysis indicated marked reduction in all hematological parameters except platelet count in group A. Conclusion: Our findings suggest that IDA and Vit B12 deficiency may coexist in young females. Monitoring Vit B12 along with iron deficiency parameters is essential to treat anemia and prevent gynecological complications. Paucity of information on their coexistence in females of childbearing age require further investigation. Keywords: Vitamin B12, Iron deficiency anemia, Microcytosis, Serum Ferritin.

Bidirectional association between diabetic peripheral neuropathy and vitamin B12 deficiency: Two longitudinal 9-year follow-up studies using a national sample cohort

AimThis study aims to investigate the association among metformin use, vit B12 deficiency, and DPN occurrence in diabetes. MethodsThis retrospective, propensity-matched cohort study was performed using National Health Insurance Service database - National Sample Cohort in South Korea. Study 1 analyzed DPN incidence according to vit B12 deficiency and study 2 analyzed vit B12 deficiency incidence according to the presence/absence of DPN. Moreover, we compared the results with respect to metformin use. ResultsIn study 1, DPN incidence per 10000 person-year (PY) was 179.7 and 76.6 in the vit B12 and non-vit B12 deficiency groups, respectively. The adjusted HR was 1.32 (95% CI; 1.21–1.44, P < 0.05) and metformin use elicited a more significant effect of DPN occurrence in patient with vit B12 deficiency (HR: 5.76 (95% CI; 5.28–6.29). In study 2, vit B12 deficiency incidence per 10000 PY was 250.6 and 129.4 in the DPN and non-DPN groups, respectively. The adjusted HR was 2.44 (95% CI; 2.24–2.66, P < 0.05), however, metformin prescription was associated with the reduced incidence of vit B12 deficiency in DPN patients (HR 0.68 (95% CI; 0.62–0.74, P < 0.05). ConclusionDPN occurrence increased in diabetes with vit B12 deficiency and the incidence of vit B12 deficiency was also high in DPN patients. However, metformin showed opposite effects in both cohorts. Further studies clarifying the causal relationship among DPN occurrence, vit B12 deficiency, and metformin use are warranted.

Liposome containing methyl jasmonate incorporated with vitamin B12 alleviates chilling injury of ‘Queen’ pineapples

In the food sector, liposome systems are utilized to boost absorptivity, regulate active-molecule release, and enhance food quality. The efficacy of liposomes containing methyl jasmonate (0.1 mM) mixed with vitamin B12 (2 μM) (MeJA+Vit B12 liposome) on the alleviation of chilling injury (CI) in ‘Queen’ pineapples by using peduncle infiltration was investigated. The treatment of MeJA+Vit B12 liposome was compared with the treatments of MeJA, Vit B12 and MeJA+Vit B12 and untreated fruits (control) during refrigerated storage at 13°C for 14 d. The treatments of MeJA, Vit B12 and MeJA+Vit B12 liposome could alleviate CI symptoms (translucency and browning in tissue adjacent to the core). Among these treatments, MeJA+Vit B12 liposome inhibited the CI symptom more than other treatments. MeJA+Vit B12 liposome retarded the increments of tissue electrolyte leakage, malondialdehyde content, lipoxygenase activity, polyphenol oxidase activity, and total phenols content of tissue contiguous to the core of the pineapples compared to untreated fruits. The treatment also enhanced the ascorbic acid content and antioxidant activities (ferric reducing antioxidant power and free radical scavenging activity) of tissue adjacent to the core. Therefore, MeJA+Vit B12 liposome peduncle infiltration is a feasible novel approach to alleviate the CI incidence of ‘Queen’ pineapples during refrigeration.

Using Denture Base For Local Treatment With Vit B12 Versus Parenteral Treatment – A New Approach

Using Denture Base For Local Treatment With Vit B12 Versus Parenteral Treatment – A New Approach

ANEMIA IN HYPERTENSIVE PATIENTS WITH CHRONIC RENAL FAILURE, WHAT ARE THE CHARACTERISTICS?

Objective: During chronic renal failure, the progressive impairment of kidney functions results in a set of manifestations, initially biological, then clinical. Anemia and high blood pressure are common complications during chronic kidney disease. The aim of this study is to determinate the main characteristics of anemia in hypertensive patients with chronic kidney disease Design and method: This descriptive work is a retrospective cross-sectional study aimed at evaluating the iron status of 70 hypertensive chronic renal failure patients. The average age in this study was 65 years with a male predominance (51%). In our study, 70 patients with chronic renal failure of all stages participated, hypertensive and anemic. The count of the blood elements and the hemoglobin assay were done by optical measurement using the ADVIA® 2120i automaton. The assay of vit B12, folate and ferritin in the blood by enzymatic chemiluminescence. Results: In our study, the mean hemoglobin was 10.18 g/dl, In our series of hemodialysis patients, mean serum ferritin was 276±207.14 ng/ml. In our population, blood pressure averages are of the order of: 130.29 ± 22.33 mm Hg for PAS, and 69.86 ±10.16 mm Hg for DBP. Regarding patients with chronic renal failure not on dialysis 43.5% of patients had serum ferritin low. 50% had normal ferritinemia, and 6.45% of patients had elevated serum ferritin. Ford's study found 2.92% of patients with low serum ferritin, 25.05% had a normal level, and 72.02% had hyperferritinemia. At 26% of patients in our population, the blood pressure figures were &gt; 140/90 mmHg, while 74% of patients reached the target . Conclusions: Chronic renal failure exposes to numerous hematological and cardiovascular type complications, which can themselves induce health problems, in addition Correction of anemia is not always beneficial for patients suffering from CKD in due to increased blood pressure. Perform periodic biological and hormonal analyzes. Recommend lifestyle and dietary measures in all hypertensive patients, chronic renal failure. Carry out awareness campaigns with the general public for a better understanding of chronic kidney disease

Low Vitamin B12 Levels and Its Association With Insulin Resistance: A Potent Cardiovascular Risk Indicator in Childhood Asthma.

Introduction As insulin resistance metabolically affects the body mass index (BMI), obese asthma children have more severe diseases than children with normal body mass index. A low level of vitamin B12 (Vit B12) is a known atherogenic factor by increasing the homocysteine level and therefore promotes cardiovascular morbidity and mortality. Limited studies have evaluated the role of serum B12 and insulin resistance among poorly controlled asthma in children. The purpose of the study was to compare the cardio-metabolic risk factor such as BMI, waist-hip ratio (WHR), insulin resistance, and vitamin B12 in well-controlled and poorly-controlled asthma patients and to determine the relationship between these parameters with the severity of asthma as assessed by Pulmonary Function Test. Methodology Based on the asthma control questionnaire and Global Initiative for Asthma (GINA) criteria, chronic asthma patients (n=60) of age 10-15 years were divided into two groups, namely well-controlled and poorly-controlled (30 each). Anthropometry was assessed by BMI and waist-hip ratio, and fasting blood samples were collected for the estimation of blood glucose, insulin, and serum vitamin B12 levels. Insulin resistance (HOMA-IR) was calculated using the formula- fasting glucose (mg/dL) x fasting insulin (µIU/mL)]/405. Forced expiratory volume (FEV1), forced vital capacity (FVC), and FEV1/FVC ratio were measured to assess the pulmonary function test. Results There were significant differences in the values of the BMI, insulin resistance, vitamin B12, and pulmonary function tests between poorly controlled and well-controlled asthma (p<0.01). The FEV1: FVC% was negatively correlated with BMI (r=0.53), WHR (r=0.50), glucose (r=0.68), insulin (r=0.68), Insulin resistance (r=0.80),and positive correlation with Vit B12 (0.73). In addition, Vit B12 and HOMA-IR correlatenegatively (r=0.76). Conclusion This study concludes that the level of Vit B12 is decreased and insulin resistance is increased in poorly controlled asthmatic children in comparison to well-controlled asthma. These factors along with the increased BMI in poorly controlled asthma can predispose to cardiometabolic risk which needs attention.

Nutritional deficiency and MTHFR gene polymorphism in obstetrics

: This study was carried out to determine the association of folic acid deficiency, vitamin B12 deficiency, hyperhomocysteinemia and methylenetetrahydrofolate reductase (MTHFR) gene polymorphism with obstetrical events linked to folic acid deficiency like neural tube defects (NTD); unexplained abruption placentae (AP), recurrent pregnancy loss (RPL) and preterm labour(PTL).: In the present study 87 pregnant females with past or present history of either neural tube defect (NTD), abruptio placentae, recurrent pregnancy loss (RPL) or preterm labour and 100 pregnant females without any such history were enrolled. Serum levels of folic acid, vitamin B12 and homocysteine in these females were estimated using chemiluminescence and Polyacrylamide gel electrophoresis (PAGE) was used to detect MTHFR gene polymorphism.: No significant association was observed between serum folic acid levels and NTD (p = 0.495), RPL (p = 0.832) or preterm labour (p = 0.724). However, folic acid deficiency had significant association with the occurrence of abruptio placenta (p = 0.001). Serum vit B12 deficiency was found to be a significant risk factor only in patients with RPL. Increased homocysteine revealed significant association with RPL (p= 0.024), abruption placentae (p=0.002) and preterm labour (0.015). No polymorphism in MTHFR gene could be revealed in the above pregnancy complications.: In the present study, deficiency of folic acid was uncommon probably due to its routine supplementation throughout the first trimester. However, preconceptional folic acid supplementation still needs to be emphasized to build up adequate folic acid levels required during embryogenesis. The relationship between vit B12 and RPL needs studies on larger number to establish the association before supplementation is suggested. MTHFR677 gene polymorphism may have remained undetected due to small sample size.

Nutritional deficiency in South African adults scheduled for bariatric surgery.

Globally, there is a rising trend in obesity, known to increase morbidity and mortality. Metabolic surgery and adequate weight loss decrease mortality but may worsen pre-existing nutrient deficiencies. Most data on pre-existing nutritional deficiencies in the population undergoing metabolic surgery is from the developed world, where an extensive micronutrient assessment is achievable. In resource-constrained environments, the cost of a comprehensive micronutrient assessment must be weighed against the prevalence of nutritional deficiencies and the potential harm if one or more nutritional deficiencies are missed. This cross-sectional study investigated the prevalence of micronutrient and vitamin deficiencies in participants scheduled to undergo metabolic surgery in Cape Town, South Africa, a low-middle income country. 157 participants were selected and 154 reported on; who underwent a baseline evaluation from 12 July 2017 to 19 July 2020. Laboratory measurements were conducted, including vitamin B12 (Vit B12), 25-hydroxy vitamin D (25(OH)D), folate, parathyroid hormone (PTH), thyroid-stimulating hormone (TSH), thyroxine (T4), ferritin, glycated haemoglobin (HbA1c), magnesium, phosphate, albumin, iron, and calcium. Participants were predominantly female, aged 45 years (37-51), with a preoperative BMI of 50.4 kg/m2 (44.6-56.5). A total of 64 individuals had Type 2 diabetes mellitus (T2D), with 28 undiagnosed cases at study entry (18% of study population). 25(OH)D deficiency was most prevalent (57%), followed by iron deficiency (44%), and folate deficiency (18%). Other deficiencies (vitamin B12, calcium, magnesium, phosphate) were rarely encountered and affected ≤1% of participants. Folate and 25(OH)D deficiency were related to obesity classification, with a higher prevalence in participants with a BMI ≥40 kg/m2 (p <0.01). A higher prevalence of some micronutrient deficiencies was noted compared with data from similar populations in the developed world. The minimum baseline/preoperative nutrient evaluation in such populations should include 25(OH)D, iron studies, and folate. Additionally, screening for T2D is recommended. Future efforts should seek to collate broader patient data on a national scale and include longitudinal surveillance after surgery. This may provide a more holistic picture of the relationship between obesity, metabolic surgery and micronutrient status inform more appropriate evidence-based care.

Flour nutritional profile, and soxhlet-extracted oilphysicochemicalbreakdown-storage performance ofwhitemelon (Cucumeropsis mannii Naudin) seed varieties from Southeast Nigeria.

White melon (Cucumeropsis mannii Naudin), is among common and yet underutilized oil seed crop within the West African region, does not have sufficient information specific to its nutrient composition for foreign consumers. To supplement existing information, therefore, we investigated the nutritional profile of defatted and full-fat flour, alongside physicochemical breakdown and storage performance of soxhlet-extracted oil from two white melon (C. mannii) seed varieties found in Southeast Nigeria. Nutritional profile involved the determinations of proximate composition, minerals, vitamins, functional properties as well as amino acid profile. Physicochemical breakdown involved the determinations of fatty acid profile, lipid breakdown parameters, as well as associated physical attributes. Results showed defatting of flours increased the protein (69.04%), carbohydrates (16.26%), crude fiber (2.68%), ash (11.9%), mineral (Na ranging from 223.92-246.99 mg/100g), and vitamin contents (Vit B1 ranging from 0.453-0.712 mg/100g). Total amino acid differed slightly when comparing miniature (30.36 g/100g) and large (22.36 g/100g) seeds. Soxhlet-extracted oil possessed low thiobarbituric acid, acid, and peroxide values (0.030 and 0.038 mg MDA/kg, 1.08 and 1.27 mg KOH/g, and 2.95 and 3,94 mEqO2/kg, for large and miniature seeds respectively), and peak linoleic acid (5 and 6.45 mg/ml, for miniature and large seeds respectively). During storage, the thiobarbituric acid and peroxide values of soxhlet-extracted oil increased yet within acceptable limits.

A Novel Hydroxyapatite/Vitamin B12 Nanoformula for Treatment of Bone Damage: Preparation, Characterization, and Anti-Arthritic, Anti-Inflammatory, and Antioxidant Activities in Chemically Induced Arthritic Rats.

The usage of nanomaterials for rheumatoid arthritis (RA) treatment can improve bioavailability and enable selective targeting. The current study prepares and evaluates the in vivo biological effects of a novel hydroxyapatite/vitamin B12 nanoformula in Complete Freund's adjuvant-induced arthritis in rats. The synthesized nanoformula was characterized using XRD, FTIR, BET analysis, HERTEM, SEM, particle size, and zeta potential. We synthesized pure HAP NPs with 71.01% loading weight percentages of Vit B12 and 49 mg/g loading capacity. Loading of vitamin B12 on hydroxyapatite was modeled by Monte Carlo simulation. Anti-arthritic, anti-inflammatory, and antioxidant effects of the prepared nanoformula were assessed. Treated arthritic rats showed lower levels of RF and CRP, IL-1β, TNF-α, IL-17, and ADAMTS-5, but higher IL-4 and TIMP-3 levels. In addition, the prepared nanoformula increased GSH content and GST antioxidant activity while decreasing LPO levels. Furthermore, it reduced the expression of TGF-β mRNA. Histopathological examinations revealed an improvement in joint injuries through the reduction of inflammatory cell infiltration, cartilage deterioration, and bone damage caused by Complete Freund's adjuvant. These findings indicate that the anti-arthritic, antioxidant, and anti-inflammatory properties of the prepared nanoformula could be useful for the development of new anti-arthritic treatments.

Investigation of Vitamin B12 as a corrosion inhibitor for mild steel in HCl solution through gravimetric and electrochemical studies

Now a days green corrosion inhibitors are highly in demand to mitigate corrosion of metal and alloys due to their non-toxicity as well as the absence of heavy metal and toxic compounds in comparison to the organic corrosion inhibitors. Since in the past research conducted on vitamin B12 as a corrosion inhibitor, the study of thermodynamic and kinetic parameters was lacking, the present work is focussed on the temperature dependence of corrosion on Vit B12(Vitamin B12) for the mild steel surface which is an influencing parameter in the present day to day industrial problems. There is a desirable need for efficient inhibitors which work well in high temperatures too. So the present study consciously restricts itself to Vit B12, a naturally occurring corrosion inhibitor. VitB12 is a water-soluble vitamin and also called cobalamin. It is an ecofriendly organometallic compound, has many adsorption sites, and is thus a promising candidate for corrosion retardation. The Potentio-dynamic Polarisation and Electrochemical Impedance Spectroscopy (EIS) are the two techniques that have been used in the analysis of the corrosion inhibition efficiency of Vit B12. It has been observed that the addition of inhibitor Vit B12, shows an enhancement in the Rct (charge transfer resistance) and a decrease in the capacitance layer Cdl value, which indicates the formation of a protective layer over the mild steel surface. The study of thermodynamic and kinetic parameters of the inhibitor adsorption over the mild steel was performed through temperature study. The surface morphology in the absence and presence of Vit B12 on the mild steel was analyzed by FE-SEM where the smooth surface is visible in the presence of inhibitor which shows the protective behavior of Vit B12.

Vitamin B12 supplementation and health behavior of Austrian vegans: a cross-sectional online survey

The number of vegans is increasing and was estimated at 2.0% of the Austrian population. Austrian vegans were found to have lower intakes and levels of vitamin B12 compared to vegetarians and omnivores. Vegans are advised to consume reliable sources of vitamin B12, e.g., in the form of dietary supplements or fortified foods. This study aimed to investigate health and supplementation behavior, with special emphasis on the supplementation of vitamin B12, and to demographically characterize the community of Austrian adult vegans. A nonrandom, voluntary sample of adult vegans with a principal residence in Austria was recruited with an online cross-sectional survey via social media and messenger platforms. Associations between respondent characteristics (gender, education, nutritional advice by a dietitian or nutritionist) and health/supplementation behaviors were examined by cross-tabulation. The questionnaire was completed by 1565 vegans (completion rate 88%), of whom 86% were female, the median age was 29 years, 6% were obese, and 49% had completed an academic education. Ninety-two percent consumed vitamin B12 through supplements and/or fortified foods, and 76% had their vitamin B12 status checked. The prevalence of vitamin B12 intake through supplements and/or fortified foods was slightly (not statistically significant) higher among women vs. men (93% vs. 89%), those who were academically educated vs. those who were not (93% vs. 91%), and those who had taken nutritional advice vs. those who had not (97% vs. 92%). Professional nutritional advice had been taken by only 9.5% of female and 8.4% of male respondents. Those who had taken advice reported a lower smoking prevalence (p = 0.05, φ = 0.05), higher prevalence of checking vitamin B12 status (p < 0.01, φ = 0.10), vit B12 intake through supplements and/or fortified foods (p = 0.03, φ = 0.05), and taking supplements of omega-3 (p < 0.01, φ = 0.14), selenium (p = 0.02, φ = 0.06), and iodine (p = 0.02, φ = 0.06). Austrian vegans can be characterized as predominantly young, female, urban, highly educated, and nonobese. The rate of vitamin B12 intake through supplements and/or fortified foods is fairly high (92%), but should be further improved e.g., by increasing the share of vegans who follow professional nutritional advice (requiring a diploma in dietetics, nutritional science, or medicine in Austria).

Hyperhomocysteinemia due to Vitamin B12 Deficiency with MTHFR Gene Mutation, an Atypical Metabolic Cause of Young Ischemic Stroke: A Case Report

Background: Vitamin B12 deficiency can impair the metabolism of homocysteine, leading to hyperhomocysteinemia that can cause thrombosis in the intracranial blood vessels resulting in a stroke. Case Presentation: A 15-year-old Muslim young boy initially presented with pallor, slurred speech, right facial weakness, and right-sided hemiplegia. On examination, he was found moderately anemic, nonicteric, and with right-sided stroke evidenced by hypertonia, reduced muscle power jerk exaggerated with extensor plantar response. There was no lymphadenopathy, bony tenderness, intellectual impairment, or organomegaly, and normal vital parameters with the unremarkable cardiovascular examination. Laboratory investigations revealed pancytopenia, with reduced Vit B12, folic acid, and moderately increased homocysteine level. Bone marrow study suggestive of megaloblastic anemia. Immunological, infectious screens; and prothrombotic markers were found negative. CT scan of the head revealed a hypodense lesion in the left parieto-occipital region, DWI sequence on MRI Brain revealed diffusion restriction in the same area while an MR angiogram of the Brain revealed occlusion of the left middle cerebral artery due to thrombus sparing a small segment after its origin. In addition, he had MTHFR c677 C&gt;T (Methyl tetrahydrofolate reductase) gene mutation and responded both clinically and biochemically after vitamin B12, folic supplementation along with aspirin in 5 months. Conclusion: Vitamin B12 deficiency along with MTHFR c677 C&gt;T gene mutation has increased the chance of thrombotic stroke. Vitamin B12 supplementation might be beneficial for patients with an MTHFR gene mutation positive. J MEDICINE 2023; 24: 51-55

Physiological Role of Arbuscular Mycorrhizae and Vitamin B1 on Productivity and Physio-Biochemical Traits of White Lupine (Lupinus termis L.) Under Salt Stress

AbstractArbuscular mycorrhizalfungi (AMF) have a key role in natural and agricultural ecosystems affecting plant nutrition, soil biological activity and modifying the availability of nutrients. Thiamine (Vitamin B1) is an essential coenzyme which incorporated in a wide range of plant metabolic processes. Thus, this research aimed to study the possibility of mitigating the negative effect of salinity stress on white lupine plant via using AMF and Vit B1through assessment growth, various physiological traits and yield components of the white lupine plant. AMF was added to the soil (0.0 and 7 g pot−1) and Vit B1was foliar applied to white lupine seedlings (0.0, 100 and 200 mgL−1) and watered by two levels of salinity (0.0 or 5000 mgL−1). Salinity stress (5000 mgL−1) resulted in significant reductions in growth photosynthetic pigments constituents, endogenous indole acetic acid (IAA), some elements &amp; productivity of white lupine in comparison to control plants. While, increasing phenols, some osmolytes and sodium compared to control (plants irrigated by tap water). Adding AMF to soil with the recommended dose boosted white lupine growth, certain physiological aspects and productivity in white lupine plants under irrigation with saltwater (5000 mgL−1). Furthermore, exogenous Vit B1 treatment with 100 &amp; 200 mgL−1not only enhanced growth and seeds productivity of white lupine plants under normal irrigation but also, improved salinity tolerance by increasing white lupine growth and productivity via inmproving photosynthetic pigments, osmolytes levels and element contents compared to their corresponding controls. Finally it could be concluded that, 200 mgL−1Vit B1 wit AMF treatment shows superiority in inducing maximum improving white lupine plant salinity tolerance.

Prevalence of vitamin and iron deficiencies at cancer diagnosis at two pediatric oncology units in South Africa

This study investigates the prevalence of vitamin and iron deficiencies at cancer diagnosis. Newly diagnosed children between October 2018 and December 2020 at two South African pediatric oncology units (POUs) were assessed for nutritional and micronutrient status (Vit A, Vit B12, Vit D, folate, and iron). A structured interview with caregivers provided information regarding hunger and poverty risks. There were 261 patients enrolled with a median age of 5.5 years and a male-to-female ratio of 1:0.8. Nearly half had iron deficiency (47.6%), while a third had either Vit A (30.6%), Vit D (32.6%), or folate (29.7%) deficiencies. Significant associations existed between moderate acute malnutrition (MAM) and low levels of Vit A (48.4%; p = .005), Vit B12 (29.6%; p < .001), and folate (47.3%; p = .003), while Vit D deficiency was associated with wasting (63.6%) (p < .001). Males had significantly lower Vit D levels (respectively, 40.9%; p = .004). Folate deficiency was significantly associated with patients born at full term (33.5%; p = .017), age older than five years (39.8%; p = .002), residing in provinces Mpumalanga (40.9%) and Gauteng (31.5%) (P = .032); as well as having food insecurity (46.3%; p < .001), or hematological malignancies (41.3%; p = .004). This study documents the high prevalence of Vit A, Vit D, Vit B12, folate, and iron deficiency in South African pediatric cancer patients, demonstrating the need to include micronutrient assessment at diagnosis to ensure optimal nutritional support for macro-and micronutrients.

Neuropsychiatric presentation of Wernicke’s Encephalopathy occurs to a pregnant Woman: A case report

IntroductionWernicke’s encephalopathy (WE) is a severe neuropsychiatric syndrome resulting from thiamine deficiency (vit B1) wich is often associated with chronic alcoholism. The classical presentation is characterized by ophtalmoplegia, ataxia and confusion.Unfortunately, WE is still underdiagnosed because it may not always show up with a classical presentation in one hand, and could also be seen in other non alcoholic condition in an other hand which delay diagnosis and managment of early proper treatementObjectivesThis case highlights the importance of considering atypical presentations of Wernicke’s encephalopathy, it’s medical etiologies and the importance of improving diagnosis to manage early treatementMethodsWe reported a case of a pregnant women who consulted for alterated mental status , asthenia and occurs to have Wernicke’s encephalopathy due to hyperemesis gravidarumResultsMrs X is a 35-year-old pregnant women with a past medical history of a cesarian, an hospitalisation in third month of this pregnancy for vomits, no known psychiatric illness or history of substance abuse. She was brought to the gynecology emergency department for asthenia and altered mental status. MRS X, was lethargic, had not eaten for several days, vomiting for more than a month. On the medical evaluation she appeared confused, disoriented, and unresponsive to verbal or manual redirection and prompting. She had also ataxia and gait incoordination. Laboratory testing was remarkable for lactic acidosis (blood lactate concentration lipasemia and normal electrolyte levels, cerebrospinal fluid (CSF) culture was unremarkable.A brain MRI was done and showed FLAIR signal abnormalities around the third ventricle and periaqueductal, suggesting Gayet-Wernicke encephalopathy. Thiamine (vit B1) 500mg thrice a day was administrated for the next days in associtation with vitamin B6.ConclusionsWernicke encephalopathy (WE) is an acute reaction to thiamine deficiency which usually presents with a classical triad. However, Clinicians tend to ignore WE in other non-alcoholic clinical settings and the diagnosis becomes even more difficult when thiamine deficiency presents with unusual neuropsychiatric signs and symptoms like catatonia. This case highlights the importance of considering atypical presentations of WE, it’s medical etiologies and the necessity of a complete medical evaluation and appropriate investigations to make prompt diagnosis and early management.Disclosure of InterestNone Declared

Does Metformin in Different Doses Cause Vitamin B12 Deficiency? A cross-Sectional Study.

The use of metformin in diabetic patients causes vitamin B12 deficiency, but there is not enough evidence about the existence of a correlation between different doses of metformin and vit B12 deficiency. Therefore, this study was conducted with the aim of investigating the correlation between different doses of metformin and vitamin B12 deficiency. This cross-sectional study was conducted on 200 patients with type 2 diabetes referred to the diabetes clinic of the central hospital of Sulaimani city in 2022. Demographic data were collected by a questionnaire and the serum level of Vit B12 data was by testing the blood samples. Data analysis was done using SPSS ver.23 and descriptive tests, chi-square, Pearson correlation and logistic regression. The results showed that 24% of patients had vitamin B12 deficiency. 45 (93.8%) patients with vitamin B12 deficiency have taken metformin. The mean vitamin B12, mean metformin consumption per year and metformin dose were significantly different between the two groups. Based on the regression model, it was shown that there was no significant relationship between the serum level of vitamin B12 and the duration of metformin medication (P=0.134). And the relationship between gender, occupation, alcohol and metformin dose (mg) was significant, so these factors have the ability to predict the serum level of vitamin B12. The results showed that vitamin B12 deficiency is common in diabetic patients who take metformin, and the vitamin deficiency will increase with the increase in the dosage.

Vitamin B12 status in term pregnant women and the cord blood samples of their newborns: A cross-sectional study.

Background and aim: In India, total vitamin B12 (Vit B12) and its active form (active B12) have not been studied in mother's blood and cord blood. We hypothesized that total and active B12 levels are sufficiently maintained in cord blood despite low levels in mothers. Methods: Two hundred term pregnant mother's blood and cord blood was collected and analyzed for total Vit B12 (radioimmunoassay method) and active B12 levels (enzyme-linked immunosorbent assay). Mean values of constant or continuous variables (hemoglobin (Hb), packed cell volume (PCV), mean corpuscular volume (MCV), white blood cells (WBC), and Vit B12) were compared in mother's blood and newborn cord blood using Student's t-test and multiple comparisons within the groups were carried out with ANOVA. Spearman's correlation (Vit B12) and multivariable backward regression analyses (height, weight, education, body mass index (BMI) and Hb, PCV, MCV, WBC, and Vit B12 levels) were also performed. Results: Total Vit 12 deficiency was highly prevalent at 89% and active B12 deficiency was 36.7% in mothers. Cord blood showed total Vit B12 deficiency prevalence of 53% and active B12 deficiency being 9.3%. Total Vit B12 (p<0.001) and active B12 (p<0.001) levels were significantly higher in cord blood when compared to mother's blood. In multivariate analysis, higher total and active B12 levels in mother's blood predicted higher levels of total and active B12 levels in cord blood. Conclusion: Our study showed higher prevalence of total and active Vit B12 deficiency in mothers compared to cord blood thus indicating their transfer to fetus irrespective of mother's status. Maternal Vit B12 levels affected cord blood Vit B12 levels.

Corneal wound healing and nerve regeneration by novel ophthalmic formulations based on cross-linked sodium hyaluronate, taurine, vitamin B6, and vitamin B12.

Introduction: To evaluate the pharmacological profile of ocular formulations based on cross-linked sodium hyaluronate (CL-SH), taurine (Tau), vitamin B6 (Vit B6) and vitamin B12 (Vit B12) using in vitro and in vivo paradigms. Methods: Rabbit corneal epithelial cells were used to assess wound healing and reactive oxygen species (ROS) formation by scratch assay and oxidative stress (0.3mM H2O2; 30min), respectively with or without ocular formulations exposure. In vivo studies were carried out on albino rabbits to evaluate corneal nerve regeneration and corneal wound healing with or without treatment with six different formulations. Animals were anesthetized, the corneal epithelium was removed, and formulations were topically administered (30μL/eye; 3 times/day for 6days). Slit-lamp observation was carried out at different time points. After 6days the animals were killed, and corneas were collected to evaluate corneal re-innervation by immunohistochemistry of selective neuronal marker β-III tubulin. Results: Formulations containing the concentrations 0.16% or 0.32% of cross-linked sodium hyaluronate, taurine, vitamin B6 and vitamin B12 accelerated corneal wound healing. Cells exposed to H2O2 led to significant (p < 0.05) increase of reactive oxygen species concentration that was significantly (p < 0.05) counteract by formulations containing cross-linked sodium hyaluronate (0.32%) and taurine with or without vitamins. The extent of re-innervation, in terms of β-III tubulin staining, was 5-fold greater (p < 0.01) in the eye of rabbits treated with formulation containing 0.32% cross-linked sodium hyaluronate, taurine, vitamins (RenerviX®) compared with the control group (no treatment). Furthermore, re-innervation elicited by RenerviX® was significantly greater (p < 0.01) compared with the group treated with the formulation containing 0.32% cross-linked sodium hyaluronate and taurine without vitamins, and with the group treated with the formulation containing 0.5% linear sodium hyaluronate (SH), taurine, and vitamin B12, respectively. Discussion: In conclusion, among the formulations tested, the new ophthalmic gel RenerviX® was able to contrast oxidative stress, to accelerate corneal re-epithelization and to promote nerve regeneration.